Provider Demographics
NPI:1326478355
Name:HULL, NICOLE (RN)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:HULL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 N OUTAGAMIE CT
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3429
Mailing Address - Country:US
Mailing Address - Phone:920-734-7160
Mailing Address - Fax:
Practice Address - Street 1:606 N OUTAGAMIE CT
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3429
Practice Address - Country:US
Practice Address - Phone:920-734-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI191241-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse